Provider Demographics
NPI:1417046194
Name:EPSTEIN, CYNTHIA SUSAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:SUSAN
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MADISON AVE
Mailing Address - Street 2:4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5428
Mailing Address - Country:US
Mailing Address - Phone:212-725-1090
Mailing Address - Fax:
Practice Address - Street 1:159 MADISON AVE
Practice Address - Street 2:4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5428
Practice Address - Country:US
Practice Address - Phone:212-725-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN39051Medicare ID - Type Unspecified